KENNEDY WIRTZ – Diagnostic Radiology Physician, NPI 1437680089

KENNEDY WIRTZ is a healthcare provider. based in Brookfield, Wisconsin. specializing in DIAGNOSTIC RADIOLOGY. They hold a License No. 71896 (WI). The NPI Number for KENNEDY WIRTZ is 1437680089

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
KENNEDY WIRTZ
NPI
1437680089
Phone
(262) 754-8000
Address
1905 N Calhoun Rd
Enumeration Date
24 March 2017
Last Update Date
8 July 2022

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF WISCONSIN
Secondary Phone
7153441234117
Graduation Year
2017 (9 years ago)
PAC ID
8527498260
Group Practice PAC ID
7113912304
Professional Enrollment ID
I20220716000603
Address ID
WI544811325ST3410XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,101 DIAGNOSTIC RADIOLOGY in WI

Provider Addresses for KENNEDY WIRTZ

  • 1905 N Calhoun Rd

    Brookfield, WI 530055036

    Phone: (262) 754-8000

    Fax: (262) 780-3396

    Type: Location

  • 4455 S 108th St

    Greenfield, WI 532282504

    Phone: (414) 427-5310

    Fax: (414) 427-5311

    Type: Location

  • 8701, West Watertown Plank Road, Wauwatosa, Milwaukee County, Wisconsin, 53226, United States

    MILWAUKEE, WI 532263548

    Phone:

    Type: Mailing

  • 9200 W WISCONSIN AVE

    MILWAUKEE, WI 532263522

    Phone: (414) 805-2060

    Fax: (414) 259-9290

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 10 Open Payments records for all available years, with a total value of $1,616.

Total Amount is formed as General ($1,616) + Research ($0) + Ownership ($0) = $1,616.

Last reported payment date: 2024-11-18 • Largest payer in this snapshot: HeartFlow, Inc. ($1,460).

Total Amount

$1,616

General + Research + Ownership

Payments

10

Total payment records

General Amount

$1,616

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-07-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220716000603IDiagnostic RadiologyWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
74177Ct scan of abdomen and pelvis with contrast139119$0
71045X-ray of chest, 1 view11097$0
77067Screening mammography9494$0
77063Screening 3d breast mammography9494$0
71046X-ray of chest, 2 views7068$0
View full utilization report →

Insurance plans in this area (ZIP 53005)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113912304View full group profile
NameSpecialtyState
-WI
Diagnostic RadiologyTX
Diagnostic RadiologyWI
Diagnostic RadiologyWI
Diagnostic RadiologyWI
Diagnostic RadiologyIL
Diagnostic RadiologyWA
-MN
Diagnostic RadiologyWI
Diagnostic RadiologyWI

Reviews

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Frequently asked questions

Does KENNEDY WIRTZ share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KENNEDY WIRTZ uses 1437680089.
Can I rely on KENNEDY WIRTZ being an active provider?
As of the registry snapshot, KENNEDY WIRTZ is marked active.
What taxonomy line describes KENNEDY WIRTZ?
For research purposes, treat KENNEDY WIRTZ as Diagnostic Radiology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is KENNEDY WIRTZ based?
KENNEDY WIRTZ is tied to Brookfield, Wisconsin in the data we show; additional addresses may exist on the full record.
Why does KENNEDY WIRTZ have multiple addresses?
6 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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